EWC ASSESSMENT FORM (SOC DIGITAL MEDIA)

ALBERTA - MANITOBA- ONTARIO - SASKATCHEWAN - BC

EMAIL: ladyjean.sanmiguel@yahoo.com / szouck2005@yahoo.com/ PHONE: +1 587 5685523 / 587 5910821 SOC DIGITAL MEDIA (Youtube - TikTok - Instagram)
STUDENT INFORMATION SHEET

PROVIDE ONE VALID ID
Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Best Email Address
example@example.com
Date of Birth

MonthDayYear
Date
Place of Birth
Residence Status in Canada
Total 2023 Income (Line 150)
Marital Status
Social Insurance Number (SIN)
Valid ID Upload:

Front and Back
Cancelof
Employment Insurance (If Applicable)
Monthly
Courses You Are Interested
High Graduation
Month/Year
Referred By:
Type the Fullname

Dependent Children Information (If Applicable)

Emergency Contact Information
FULL NAME
COMPLETE ADDRESS
CONTACT NO.
RELATIONSHIP TO YOU
Spouse Information
Full Name
Date of Birth

MonthDayYear
Date
SOCIAL INSURANCE NUMBER (SIN)
TOTAL INCOME 2023
By signing and submitting this student information sheet, I confirm JEAN SAN MIGUEL as my exclusive marketer for East West College and/or Nova Career College. I authorize them to collect my information and assist with my application process. I certify that all information provided is true and accurate to the best of my knowledge. I accept full responsibility for any false statements or inaccuracies. Additionally, I acknowledge that providing false information may result in my dismissal from the program, for which the marketer is not responsible. I fully understand the guidelines and processes of the school procedures.
Signature
Date Signed

MonthDayYear
Date
Disclaimer: This assessment form and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this form in error, please notify the school marketing specialist (587-568-5523). Please notify the sender immediately by email if you have received this form by mistake and delete this from your system. If you are not the intended recipient, you are notified that disclosing, copying, distributing or taking any action in reliance on the contents of this information is strictly prohibited.
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STUDENT INFORMATION SHEET